Heart India

EDITORIAL
Year
: 2020  |  Volume : 8  |  Issue : 2  |  Page : 35--37

Preface to the second issue of Heart India 2020


Alok Kumar Singh 
 Department of Cardiology, Opal Hospital, Varanasi, Uttar Pradesh, India

Correspondence Address:
Dr. Alok Kumar Singh
Department of Cardiology, Opal Hospital, Varanasi, Uttar Pradesh
India




How to cite this article:
Singh AK. Preface to the second issue of Heart India 2020.Heart India 2020;8:35-37


How to cite this URL:
Singh AK. Preface to the second issue of Heart India 2020. Heart India [serial online] 2020 [cited 2020 Sep 19 ];8:35-37
Available from: http://www.heartindia.net/text.asp?2020/8/2/35/291357


Full Text



In this issue of “Heart India,” we are publishing 12 original research articles and two case reports. The cardiac toxicity (cardiotoxicity) from cancer therapy has become one of the leading causes of morbidity and mortality in survivors.[1] Speckle-tracking echocardiography (STE) is a promising technique, to quantify regional left ventricular (LV) function and right ventricular function, which appears to be valuable for unmasking of cardiac pathologies. STE is an angle-independent technique which allows an accurate assessment of segmental myocardial deformation by grayscale-based imaging analysis frame by frame. In the first original research article, Singh et al. have demonstrated that there was a significant worsening of LV systolic function as measured by the strain parameters on STE in cancer patients on chemotherapy and/or radiotherapy, which was not detected by two-dimensional (2D) echocardiography alone. STE may thus be a valuable tool in picking up early cardiotoxic changes in cancer patients.

Patients with acute coronary syndromes (ACSs) who undergo revascularization procedures often have suboptimal functional results in spite of open epicardial arteries due to either structural (cell membrane disruption) or functional (reperfusion-associated injury) reasons (the “no reflow” phenomenon).[2] In the second original research article, Jha et al. have demonstrated that, in patients with ACS and a single-vessel disease on undergoing percutaneous coronary intervention (PCI) for recent ACS, the use of intravenous nicorandil was associated with a significant improvement in myocardial performance index at 1-month follow-up. There was no significant difference in the acute angiographic parameters, major adverse cardiac events, LV ejection fraction (LVEF), or wall motion score index.

The incidence of congenital heart disease (CHD) varies from about 4/1000 to 50/1000 live births in different studies, of which 2.5–3/1000 live births present as severely ill in the neonatal period or early infancy and need expert cardiac care.[3] In the third original research article, Rashid et al. have studied the incidence of CHD in fetus by fetal echocardiography (FE). As per this study, the most common indications for which fetal scan was abnormal routine ultrasound which was mostly low-risk pregnancies. Dedicated cardiac screening should be part of the routine anomaly scan. Detailed FE should be done in all patients who have any doubt on anomaly scan.

Aortic arch atheromas are the second most prevalent cardioembolic risk factor for stroke after atrial fibrillation (AF) and are found in 16%–20% of all patients with stroke or transient ischemic attack (TIA) in various studies.[4] In the fourth original research article, Palaparti et al. have demonstrated that, in one-third of the cryptogenic stroke/TIA patients had aortic atheromas and half of them had atheromas ≥4 mm. In the fifth original research article, Moulick et al. have studied coronary artery anomalies in adult patients undergoing coronary angiography for various indications. In this study, most common among all the anomalies was origin of the right coronary artery from the left coronary sinus.

Obstructive sleep apnea (OSA) is the most common type of sleep apnea caused by complete or partial obstruction of the upper airway. It is characterized by repetitive shallow pauses in breathing in spite of efforts to breathe normally. In the sixth original research article, Badrinath et al. have studied the predictors of impending cardiac arrhythmias by electrocardiographic markers in proven OSA patients. Authors of this study have concluded that the increase in duration of P wave, QRS duration, and prolongation of Tp–Te interval in electrocardiogram is associated with increasing severity of OSA tends to possess significant risk of developing impending atrial and ventricular arrhythmias, respectively.

Prosthetic valve thrombosis is defined as any obstruction of prosthesis by noninfective thrombotic material or valve-related clotting impairing the function of the valve. In the seventh original research article, Mansuri et al. have studied the clinical profile of prosthetic heart valve thrombosis and outcome analysis of fibrinolytic therapy versus surgical management. Authors of this study have concluded that, in case of recurrent prosthetic valve thrombosis, surgery should be preferred over fibrinolytic therapy. Patent ductus arteriosus (PDA) is one among the most prevalent CHDs in the current times. In the eighth original research article, Shah et al. have studied the safety and efficacy of transcatheter device closure of PDA in pediatric patients. Authors of this study concluded that percutaneous transcatheter closure of PDA using ADO device was safe and effective in the pediatric population with minimal complications.

Despite women's less extensive or less severe disease among patients with stable and unstable angina pectoris compared to men, the former have more severe symptoms or they are more symptomatic independent of the extent of disease. Although men experience coronary events four times more than women, women are more likely to die after the first episode of an acute myocardial infarction. In the ninth original research article, Sharma et al. have studied the gender-based differences in coronary artery disease (CAD) from a North Indian state in a prospective observational study.

Authors of this study have concluded that despite its atypical presentation, CAD has the worst outcome in women than men. Greater awareness of these gender-based differences will significantly improve the management and outcome of CAD in women.

2D) strain is a novel technique which evaluates LV systolic functions more objectively and quantitatively and does not have the limitations seen in ejection fraction (EF), tissue Doppler imaging, and Doppler strain. In the tenth original research article, Singh et al. evaluated the role of 2D strain in the assessment of LV systolic function and the relationship between the presences of AF and LV dysfunction in patients with mitral stenosis (MS). Authors of this study have concluded that, despite normal LV dimensions and EF, there was any significantly lower global longitudinal systolic strain (GLSS) in MS patients compared to healthy controls. Patients with AF had significantly lower GLSS value than the sinus rhythm group among patients with MS.

Heart rate (HR) is correlated with peripheral and central blood pressure, which may be determinant in the development of hypertension (HTN). In the eleventh original research article, Vasista has assessed the HR in patients with and without HTN and identified the determinants of HR in patients with HTN. Author of this study has concluded that HR is significantly higher in patients with HTN than nonhypertensive controls in the central Indian population. CHDs are the most common fetal congenital defects, and until nowadays, most of them are bypassed without prenatal diagnosis. In the twelfth original research article, Bashir et al. have studied the incidence of fetal CHD in high-risk mothers, various indications of FE, and their postnatal outcome in developing nation with limited resources. Authors of this study have concluded that FE is a very useful tool for prenatal diagnosis of CHD. It has proven itself in the diagnosis and management of fetal arrhythmia, even in developing countries with limited resources.

With increasing rates of complex and high-risk PCI, intracoronary imaging plays an important role in the optimization of PCI results on a daily basis in cardiac catheterization laboratory. Optical coherence tomography (OCT) scores over intravascular ultrasound (IVUS) as it offers clear, photographic-quality images, as opposed to grainy, lower-resolution IVUS images. In the first case report of this issue, Palaparti et al. have highlighted the utility of real-time 3D-OCT in predicting restenosis by identifying geographic miss between overlapping stents after complex multivessel PCI. In the second case report of this issue, Nath et al. have reported a rare early presentation of rheumatic valve disease in a 2-year-old child. Authors of this case report highlighted the fact that rheumatic fever/rheumatic heart disease is still a very prevalent disease in India yet is underdiagnosed and underreported.

References

1Doyle JJ, Neugut AI, Jacobson JS, Grann VR, Hershman DL. Chemotherapy and cardiotoxicity in older breast cancer patients: A population-based study. J Clin Oncol 2005;23:8597-605.
2Ragosta M, Camarano G, Kaul S, Powers ER, Sarembock IJ, Gimple LW. Microvascular integrity indicates myocellular viability in patients with recent myocardial infarction. New insights using myocardial contrast echocardiography. Circulation 1994;89:2562-9.
3Hoffman JI, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol 2002;39:1890-900.
4Sen S, Hinderliter A, Sen PK, Simmons J, Beck J, Offenbacher S, et al. Aortic arch atheroma progression and recurrent vascular events in patients with stroke or transient ischemic attack. Circulation 2007;116:928-35.